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constant feeding; supplementing

Hello all, I have a question regarding my five week old little guy, I'm trying to work towards exclusively breastfeeding him, but we are stuck in a rut with supplements, I nurse him as much as he would like, but he will nurse for 2-3 hours and then still be very hungry so I give him a small bottle to tide him over until there is slightly more milk available. I know the general principle is to do less and less formula, but how long should I make him nurse before relenting and giving him a bottle? Also I read that fenugreek might increase milk production, but the bottle says not to take while nursing? Any thoughts or advice would be much appreciated!

Re: constant feeding; supplementing

Can we have some more info, please? Baby's weights so far, # of wets and poops a day, why ddid you start supplementing, how much formula does he get in a day, is there any pain while nursing? It's definitely possible to get to exclusively breastfeeding. What sticks out is the 2-3 hours. If every session is like that, I would recommend seeinganIbclc to assess the situation. Maybe there is something hindering proper milk transfer.
Everything says do not take while breastfeeding. It's a CYA deal. Check out infantrisk.org for more info about nursing and medications.

Re: constant feeding; supplementing

He weighed 8.7 at birth, 9.1 @ two weeks, 10.14 @ four weeks, average is one or two bowel movements a day and tons of wet diapers. He had jaundice and I had to supplement with formula and haven't been able to stop. I'd say he normally gets 8-10 ounces of formula in a 24 hour period, no pain while nursing, a small amount when he first latchs on, and some soreness from the constant nursing, but nothing extreme. He will nurse for hours and still not be satisfied, pretty much every time we nurse, or he will nurse for an hour, sleep for 10-15 minutes then go for another hour, until he gets frustrated, stops trying, starts screaming and I give him a bottle. I'll have check out going to see someone I guess.

Re: constant feeding; supplementing

This link covers weaning from formula supplements: http://kellymom.com/bf/got-milk/basi...rease-formula/ Basically, you want to nurse as much as possible and gradually decrease the size of the formula supplements you are offering. Pumping after feedings, using a good double electric pump, will speed the process. As soon as you can supplement with your own milk rather than formula, you know your supply is equivalent to baby's needs.

One thing that is really important to realize is that milk is ALWAYS being made. So there's generally no need to "tide baby over" with a bottle while waiting for your breasts to "fill up." Unless, of course, the baby is unable to nurse well enough to access the milk! I agree with the PP that a trip to the IBCLC is a very good idea- 2-3 hours of nonstop nursing does not sound entirely normal to me, especially combined with the nipple soreness. When a baby is properly latched, even constant nursing will not result in nipple soreness. A poor latch often means nipple soreness for mom, plus slow/inadequate feedings for baby.

Some more questions for you:
- any chance that you're pregnant?
- are you using contraception, and if so, what kind?
- do you have a pump, and if so, what made/model?
- how big are the bottles you are offering?
- are you using a slow-flow/newborn nipple on the bottles?

Re: constant feeding; supplementing

Depending on HOW much your child is being supplemented will affect how to handle it at this point but the overall answer to questions is NEVER. You don't stop. You don't give up and give formula. You keep the baby at the breast. And yes at this young age that means they spend MOST of their time there. Now five weeks in your supply has probably been negatively affected so you probably need to wean off supplements, but for any other Noob who has a new baby that is reading this thread the answer is THIS IS NORMAL. You allow your newborn unlimited access to your breasts. Yes this means it's all you do for the 1st few weeks. Yes it means we all spend the 1st 6 weeks in our PJs on the couch. Just feeding the baby all. Day. long. The fact that this is happening to you DO NOT MEAN you need to supplement. Or that you aren't making enough milk. You are. It's all supply and demand. A newborns instinct is to regulate your milk supply. That means constant stimulation. You allow it. That's what you do.
Esther 8-10 oz isn't much. You can wean from that amount of supplement in a week to 10 days if you are diligent. But you have to be willing to not cave to do the crying. Because you want him to forget that there is an easier way to get food. So when he screams I would take off all my clothes and either crawl into bed with him or into a hot shower. And Nurse some more!!

Re: constant feeding; supplementing

Also I read that fenugreek might increase milk production, but the bottle says not to take while nursing?

ok that is funny, in a sad way. Why else does anyone take fenugreek?

but some herbs do carry risks for some moms. Kellymom.com has a good article on fenugreek.

Depending on your answers to mommal’s questions, All signs at this point suggest you can get off this formula train very quickly. Your baby's weight gain is excellent and I assume jaundice is no longer a concern. Your baby's behavior is possibly totally normal-babies fuss for many reasons aside from hunger. Your production will be helped most by baby nursing more. Switching sides during a feeding may help with production and breast compressions may help with the long feedings. Have you tried these?

I am mostly concerned that the latch is off due to your report of soreness. This could be leading to a milk transfer issue. So yes, if you can see a board certified lactation consultant for that and for help weaning off the formula that would be great.

Re: constant feeding; supplementing

Originally Posted by @llli*lllmeg

ok that is funny, in a sad way. Why else does anyone take fenugreek?

It's an element in Middle Eastern and Indian cuisine, and it is also used for blood sugar issues, upset stomach, constipation, atherosclerosis, and a whole bunch of other stuff! The fact that fenugreek is such a common ingredient in cooking implies that those boilerplate warnings on the bottles can be ignored.

Re: constant feeding; supplementing

Thanks for all the great advice guys, I know my supply got shot early on, we have had two mastitis adventures and i stopped nursing for two days because my nipples were raw and bleeding, but I am glad that you guys think that we can come back from this, to answer mommal's questions, not pregnant (unless its the immaculate conception ), I'm not on birth control, I do have a pump, evenflo SimplyGo, I think its a walmart special brand, it was fairly cheap, I offer two ounces at a time and I use a newborn nipple, I switch sides a lot, whenever he gets frustrated I switch, I do breast compressions as well, only when he gets worked up though,
I actually have my 6week Dr appt on monday, so I'll ask her about the lactation consultant and see if that is available, I don't normally pump after he nurses, I figured there was no point in pumping if theres nothing there, but I did today after one nursing session( only an hour this time! ) and only managed to get 10ml, not sure if that is good, he got most out, or bad, he gave up and milk was still available, but he sucked it down and fell asleep I'll have to continue pumping after he nurses tho.
Oh last question I promise! In theory I understand the breast is never really 'empty' but if I can't express any milk by hand should the lo still be able to get something? I'm just so worried that he is hungry and that I'm failing him in some way...

Re: constant feeding; supplementing

As long as a baby is a decent breastfeeder- he can get a good latch, he has good suck-swallow coordination, he's not falling asleep too quickly when nursing, not tongue-tied- he's always going to be better at emptying the breast than hand-expression or even the best pump. The fact that your LO is such a slow feeder makes me wonder if something is off with his latch or his tongue- which is why seeing the IBCLC is such a good idea at this point. Quite possibly there's nothing wrong, and he's just a slow nurser right now- but IMO it makes sense to have a professional check things out.

As you make the effort to transition away from bottles and supplements, the best way to know if your baby is getting enough is to keep a careful eye on his diaper output and weight gain. When a baby is producing sufficient wet/poopy diapers, he is getting enough to eat. If you still don't feel sure about his intake, you can take a further step and acquire a professional baby scale for home use. By weighing baby before and after nursing, and subtracting the before from the after, you can gain a very accurate picture of how much baby eats over the course of a feeding.

Your post-nursing pump output wasn't bad, considering that you are using a very lightweight pump. If you use a batter machine and pump more frequently, I am sure you'll ditch the supplemental formula in no time!

When you go in to see the doc for your 6 week check-up, she'll probably ask you what you want to do about birth control. Since you're struggling a bit with supply right now, you probably want to choose a non-hormonal method. Hormonal contraception, even the "safe for breastfeeding" progestin-only methods, can cause supply reductions in some moms. If you want to use a hormonal method, that's fine- just wait until you feel like breastfeeding is going better and you've been able to ditch the supplements.